Dr. Jay Orringer, Renaissance Medical Center for Aesthetic Surgery plastic surgeon who did Angeline Jolie’s breast reconstruction, promotes the idea of having a “breast team” for a more effective breast cancer treatment.
Orringer believes that a team approach is needed to manage breast cancer. From the time a woman is diagnosed with cancer up to considering her treatment options, plastic surgeons must be greatly involved.
Jolie, as she wrote in an op-ed in the New York Times in May, said she carries a mutation of BRCA1 gene, a gene that increases her risk of having breast cancer. She then decided to have a prophylactic mastectomy, which would cut her chances of developing breast cancer by 90 percent. Orringer was part of the team who cared for Jolie during the operation.
During a doctor’s convention in Hollywood, Fla., he spoke about the role of the “breast team” on breast cancer treatment.
The “breast team” consists of a gynecologist, medical oncologist, radiation oncologist and general surgeon, who can educate women about the different management options and how it affects the quality of breast reconstruction. Additional support system which includes physical therapists, psychotherapists and support groups may also be much needed.
“A woman has the right to speak with not just the breast surgeon, but also a plastic surgeon, to understand the various treatment options and their implications,” he told LiveScience.
There are two ways of treating breast cancer: breast-conserving surgery, wherein the tumor is taken out then the patient undergoes radiation therapy; and mastectomy which means removal of the breast.
If the woman chooses the first option, there will be permanent changes to the quality of the breast tissue and chest wall. And if the cancer recurs, the quality of breast reconstruction decreases.
“What I would like to avoid in the future is a woman coming in for breast reconstruction after previous radiation therapy, and saying, ‘I had no idea about the implications of the radiation I had.’”
Furthermore, a plastic surgeon could suggest timing and techniques of reconstruction. The patient can choose between implant and borrowing a fat tissue from another part of the body. Both have good and bad effects.
When it comes to aftermath, there are a number of surgical techniques that look like cosmetic techniques that give positive aesthetic outcomes.
"The idea of a scar that goes across the chest is increasingly becoming a scar of the past," Orringer said.
"A woman is the captain of her own health care team, and the doctors involved should be co-captains with her, working with her to help achieve the best outcomes," he added.